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Asherman’s Management: My point of view Dr. R Manchanda

Asherman’s Syndrome is defined as the presence of adhesions and/or fibrosis inside the uterine cavity. Other terms used to describe the condition are ‘intrauterine adhesions’, uterine synechiae, sclerotic endometrium or endometrial sclerosis and Fritsch –Asherman Syndrome.

It was first described in 1894 by Heinrich Fritsch and further classified by Joseph Asherman in 1948. It is found in 5-39% of women with recurrent pregnancy loss.

The condition results mainly due to trauma to the basal layer of endometrium due to any surgical procedure (Amenorrhoea Traumatica) like dilatation and curettage, caesarean section, myomectomy or due to chronic endometritis caused by pelvic inflammatory disease including genital tuberculosis.

The predominant symptoms are secondary amenorrhoea, hypomenorrhoea and infertility. The gold standard for diagnosis is hysteroscopy, which helps in assessment of degree of scar formation.